Caring for Parents: Being One Step Ahead

Thoughts and tips on practical ways to be prepared for parental decline

Credit: Micheile Henderson, unsplash

We went to see some old friends recently in Malvern. They’d made the move from Hertfordshire, a county just north of London, to be near their parents in the last few years of their life. Apart from discovering what a gem of a town Malvern is (once home to Vaughan Williams and where CS Lewis went to school) I got to swap stories with them on the challenge of this stage of life.

‘You’ve got to be one step ahead all the time,’ she advised as she poured me a large G&T. ‘That way you minimize the burden on you as their care needs mount.’

I nodded vociferously. I’ve known this instinctively for years, as has my mother who, like me, naturally plans ahead, foresees issues or problems. Together with her and my twin brother, I’ve done all I can to try and put things in place for her as her health has deteriorated. But it was reassuring to hear those words as there have been many times when I’ve pushed for something which Mum wasn’t so sure she needed, but in the end did.

Take, for example, organising for a carer to come in for just an hour a day after my brother moved out in May this year. She wasn’t sure she really needed someone, but she soon changed her mind after she fell ill and then started to fall. Having someone in place made it easier to up the care when she really needed it.

As we tucked into dinner that evening, I was aware of a sadness hovering over me as her words percolated through my mind. The fact is that we’ve simply not been able to be one step ahead for Mum on a few issues, one in particular: her accommodation.

Owing to my brother feeling unable to live independently of her all his life, and she not understanding what the root of that was, she has not been able to downsize to a manageable retirement flat like my friend’s parents did. Whilst she did ‘downsize’, ten years ago, to a property that my brother could live semi-independently in, it turned out to be not much smaller than the original Victorian family home she moved from – and with more maintenance issues than she’d bargained for. As a result, since my brother moved out, she is now left living in a four bedroom extended semi and a large garden.

This is real life. Even with the best foresight in the world, putting into action what we think or sense needs doing is far from simple.

View over Malvern from the Hills, Siobhan Calthrop

You may have parents who are reluctant to move house or stop driving, who aren't fully aware of their own decline (particularly in dementia cases) or perhaps are aware but don’t want to give into the reality of ageing, to accept that change is happening and their independence is slowly waning. The fact is, our parents are, or once were, fully independent, sharp-witted, capable individuals who have not only looked after themselves for decades, but have most likely looked after you.

They are used to making their own decisions, making do, looking on the bright side, keeping calm and carrying on. Their perception of what they can, or rather, want to do often differs from what you as the outside observer can see. It’s a tricky business.

Or you may have siblings who don’t agree with your assessment of the situation. They may live abroad and can’t see your parent’s decline. Or, as is the case of a friend of mine who recently returned from living in Canada, her sibling, who lives only 5 minutes away, can’t see the decline that is so obvious to her. Still a tricky business.

If any of this sounds familiar, you’re in the right place. Many others reading this will have similar challenges. We’re all facing issues that we likely have no previous experience of. Sounds like parenting, right? Although the key difference is that we don’t have an NCT group to give us advice on what to do! (Now that’d be a good idea - we could call it the NCGT: the National Carers of Grandparents Trust!)

Tips & Advice

In the light of this, I thought it would be helpful to share with you the key areas that I’ve found it good to at least try to be one step ahead, how to do that, and how I’ve got around that where it’s not been possible. It’s far from exhaustive so please do share your own tips or ideas in the comments.

Trial Carers

If your parent/s can afford it, getting in a carer for a few hours a week before they are really needed is my top tip. Finding a care agency can take time, as can getting to know your parents’ needs. Their need for care can suddenly increase if they become unwell or have a fall. Once you’re on their books, increasing care hours is much simpler. You also get a feel for that agency and the carers. I hired a care agency after my mum was hospitalised with pneumonia two years ago, not just for the care, but to try them out. We ended up not going back to them when we needed care for Mum as their contracts weren’t flexible and they were expensive.

National Cancer Institute, Unsplash

I’ll write more about this topic in the new year including advice on different types of care, and benefits or other support available such as the UK state benefit, Attendance Allowance which can make a real difference to care costs.

Downsize or Adapt

Where possible, downsize, and do so when your parents are fit enough to cope with the stress of the move. In the UK, we have very limited types of retirement accommodation, so it pays to look around early. Some retirement flats offer fantastic living accommodation, can be very sociable, and include the option to have a carer when needed. But research them thoroughly, talk to residents where possible to find out what it’s actually like living there. ‘Sheltered living’ can often be less sheltered than you’re led to believe.

If downsizing isn’t possible or they really don’t want to, there are ways to make the home safer and cheaper to run. We’ve installed a stair lift, security lights, handles on the walls, adapted steps and bathroom adaptations. If your parent has a health condition, your GP can refer you to Occupational Health who will come and fit many items for free so check that out!

Ditch the car, embrace taxis

Bruno Martins, Unsplash

This is a biggie and can be really tricky. As their eyesight, cognitive skills or confidence wanes, driving can become risky and a real source of tension between parents and children. But for many, giving up their car is tantamount to losing their independence completely. My mum’s driving was worsening to the extent that everytime she came to see us there’d be another dent in her car (and she came round often!). When she hit a motorcyclist at a junction (thankfully he wasn’t hurt and there were no charges) it was a wake up call. We said she needed to ditch the car and start using taxis. But try telling a person brought up during the war to spend money on taxis!

So we sat down and worked out her current car costs and compared it with taxi fares for a year. It was far cheaper. We won her over.

Set up a Password manager

Willian Justen de Vasconcellos, Unsplash

We all know how tech and our parents aren’t always the best of friends. If I could have a pound for every time my Mum mis-remembered her password (and she has a notebook full of them) I wouldn’t need to be shopping at Aldi :-) The answer isn’t free or simple to set up, but you’ll love me for this suggestion in years to come: set them up with a password manager. They will only need one master password to get into the 50 million or so they may have. Or do what we have done and input all their crucial passwords into your own password manager account. That way you can get into key accounts remotely if needed. We use 1Password.com but there are many others out there. PS Added bonus: if you have the Family account, your adult children can use it for their passwords too. You can also store NHS and passport info on it too.

IHT, Wills, Trusts and PoA

If you’re lucky, your parents will be on top of their finances, have an accountant or advisor. If, like my mum, your parent doesn’t have a head for figures, or never replaced her accountant when they retired, you may have some unpicking to do to ensure their finances are in good shape for when they die. Do your research about Inheritance Tax rules, and the gifting allowances. Martin Lewis’ Money Saving Expert website is the go-to resource on this.

Even though my mum has a good solicitor, she somehow hadn’t fully comprehended the importance of documenting what she has gifted, or that she could give sums of £250 per year to family on top of the £3k annual allowance.

Similarly with their Will, it’s wise to ask when they last revised it. If they have inherited a large sum of money since, the Will may well need revising in case they had decided to leave property to one sibling and savings to another (this has happened to someone I know).

In relation to that, getting Powers of Attorney for Finances and for Health is critical in case they become unwell or lose capacity. When my mum was hospitalised with pneumonia and I needed to arrange for her to go into a care home for a fortnight afterwards, I could not have signed any forms without proof of PoA. It’s actually simpler to set up than you think, you don’t need to pay for an expensive solicitor to draw one up for you.

Lastly, I’ve recently heard some banks offer Carer’s Cards where the parent can put a limited sum onto the card for a carer to use. Not only is this a safe and secure way for a paid carer to do shopping, but it avoids the need for your parent to refund you when doing online shopping. If you do this often, and for large sums, those refunds might be mistaken for gifts and therefore be liable for IHT (I know, crazy!). I’ve only just recently realised this and so I’m helping my mum go through her bank statements to identify what is and isn’t a gift. I can think of other things I’d rather be doing.

Get to know their GP

If you’re going to be caring for them, managing their care or they live alone, their GP is someone you’ll need, or at least want, to get to know. Surgeries often want to know who is the primary family carer, and it will mean you’re able to call the surgery on their behalf or speak to their GP when they’re unwell. If they’re alone, they should (let’s hope) take that into account when deciding if they can have a home visit or the type of medication they prescribe.

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